12:00 PM Sunday, October 22 (PDT)
2:00 PM Sunday, October 22 (PDT)
All fields are required unless otherwise specified.
Has the patient visited this facility before?
Would you like to enter the insurance information now?
Primary Insurance Information
Relationship to Insurance Holder
Patient is the policy holder
Patient is the spouse of the policy holder
Patient is a child of the policy holder
Patient is employee --workers comp
Would you like to be notified via text?
Msg & data rates may apply.
Terms and Conditions
I understand that online check-in is not to be used for life threatening conditions. I do not believe that the patient's condition is life threatening. In case of life threatening conditions, I understand that I must call 911 immediately or proceed directly to the nearest emergency room for immediate medical attention.
What does this mean?
I consent to be contacted by email, and understand that the email may contain sensitive, personal health information. I understand that email messages have inherent privacy risks and that information may be seen or accessible to others during transmission.
Read more about these risks.
Our system indicates that you are younger than 13. The Children's Online Privacy Protection Act of 1998 (COPPA), a United States federal law, prevents us from collecting your information. Unless you indicate that you are an adult and entering this on behalf of a child, you cannot use this service.
I am above the age of 18 and entering this information on behalf of my child, or a child for which I have legal responsibility.
(It's FREE. Cancel any time. And, it helps us serve you better when you arrive.)
Definition of an Emergency
Risks of Using Email